# Nesfatin-1 as a Potential Biomarker for Ischemic Stroke: A Case-Controlled Study of a Comparative Analysis of Patients with and Without Internal Carotid Artery Stenosis

## TL;DR

This study explores nesfatin-1 as a potential biomarker for ischemic stroke, finding that its levels are significantly lower in stroke patients compared to healthy controls.

## Contribution

The novelty lies in investigating nesfatin-1's potential as a biomarker specifically for ischemic stroke associated with internal carotid artery stenosis.

## Key findings

- Nesfatin-1 levels were significantly lower in stroke patients compared to controls (p < 0.001).
- A cut-off value of ≤30.62 pg/mL showed 77.03% sensitivity and 83.33% specificity for detecting stroke.
- Nesfatin-1 demonstrated moderate diagnostic potential with an AUC of 0.773.

## Abstract

Objectives: Recently, the need for early diagnosis of modifiable risk factors involved in the etiology of stroke has been highlighted in the literature. Nesfatin-1 is a peptide expressed in the central nervous system and peripheral tissues and has been used as a biomarker in recent years. This study aimed to determine the association of ischemic stroke with internal carotid artery stenosis according to nesfatin-1 level and whether it could be used as a biomarker. Methods: A total of 118 patients were included in the study. Three groups were defined: acute stroke patients with symptomatic internal carotid artery stenosis, acute stroke patients without internal carotid artery stenosis, and a control group. Nesfatin-1 levels were measured and compared. Results: The median value was 22 pg/mL in acute stroke patients with internal carotid artery stenosis, 24.3 pg/mL in acute stroke patients without internal carotid artery stenosis, and 46.4 pg/mL in the control group. There is a difference between the median values of nesfatin-1 according to the stroke groups with the control group (p < 0.001). When a cut-off value of ≤30.62 was taken for nesfatin-1, an AUC value of 0.773 indicated statistical significance (p < 0.001). Sensitivity was 77.03%, specificity 83.33%, PPV 90.48%, and NPV 63.83%. The main limitations of our study are the small sample size and the fact that the function of nesfatin-1 is not completely known. Conclusions: Although we found that nesfatin-1 levels were lower in ischemic stroke patients compared to controls, its diagnostic potential indicates a moderate discriminatory ability with an AUC value of 0.773. Therefore, whether it is suitable for clinical use will be demonstrated by studies in larger and multicenter cohorts.